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District nurses 'face extinction'
District nurses could become a thing of the past in little over a decade, experts have estimated.
Unless urgent action is taken, "critically endangered" district nurses - who work in the community caring for people in their own homes - could become extinct by 2025, the Royal College of Nursing (RCN) said.
In the last decade there has been a 47% reduction in the number of qualified district nurses working in communities across England, according to new research by the National Nursing Research Unit at King's College London.
The NHS and successive governments have said that care needs to be taken out of the hospital and delivered closer to home.
But the study, commissioned by the RCN, found that of the district nurses left, a third of the workforce are over the age of 50 and nearing retirement.
To plug the gap, an additional 10,000 district nurses are needed across the country, the RCN said.
A spokeswoman said that this is the "only way" to meet the demands of an ageing population.
The research, which saw 2,400 district and community nurses polled, found that most community staff are "pushed to breaking point", the spokeswoman said.
A quarter said they had seen more than 12 patients on their last shift, meaning the time actually spent with the patient was stretched, she added.
Many of those questioned raised concerns about the time spent with patients, with the nurses on average spending just 37% of their time delivering care. And eight out of 10 said they had worked additional hours on their last shift.
The RCN, which is holding its annual congress in Liverpool this week, has also called on health officials to make training nurses have a mandatory placement in the community.
Peter Carter, chief executive and general secretary of the RCN, said: "People are living longer, but not necessarily healthier, lives. This trend will grow over the coming decades and presents a very specific nursing challenge.
"The district nurse role is the foundation of a system which should be able to manage conditions and keep sick and frail people at home. Remove those foundations and the whole edifice could come crashing down.
"The NHS, and the people who run it, have long paid lip service to the ideal of moving care closer to home. But many people up and down the country are still in need of expert care from district nurses.
"By 2025, there will be many thousands of families with frail older relatives, who may well have survived a number of illnesses - and when they look for help to manage at home, it simply won't be there.
"It looks as though the NHS is trying to run these services on goodwill alone and staff should not be spending their working lives at breaking point. Patients simply cannot wait forever for these services to be properly resourced.
"When expert care at home is not available for vulnerable or dying people, the end result is unnecessary hospital admissions which are both expensive and distressing. It is a false economy to leave patients in limbo, rather than training and employing enough district nurses to meet demand."
A Department of Health spokeswoman said: "The Francis report has had a significant effect - lots of hospitals are employing more nurses on the wards. We now need to make sure this happens across the NHS and in the community.
"That's why the chief nursing officer has set up a working group which is looking specifically at what we can do to increase the number of community nurses and we are committed to training 10,000 more frontline community staff by 2020.
"We're also working with the NHS to invest £1 billion in new technology so that staff have more time to spend with patients, not paperwork."